Client Interview Sheet

FAMILY INTERVIEW FORM

FAMILY LAW MATTERS

DATE: ______

LAWYER: ______REFERRED BY: ______

A. CLIENT INFORMATION

CLIENT’S FULL NAME:______

PRESENT ADDRESS:______

______

MAILING ADDRESS:______

(if different)______

HOME PHONE: ______WORK PHONE: ______FAX: ______

EMAIL: ______

CELL:______OTHER CONTACT PHONES: ______

DATE OF BIRTH: ______PRESENT AGE: ______

PLACE OF BIRTH: ______

MAIDEN NAME: ______

SURNAME BEFORE THIS MARRIAGE: ______

MARITAL STATUS AT TIME OF MARRIAGE:

Single: _____Widowed: _____Divorced: _____

OCCUPATION: ______

EMPLOYER’S NAME AND ADDRESS:

______
______

HOW LONG AT THAT EMPLOYER? ______

GROSS ANNUAL INCOME: $______

FREQUENCY OF PAYMENT: Bi-weekly: _____ Bi-monthly: _____ Monthly: _____

TOTAL INCOME ON LAST TAX RETURN: $______

NET TAXABLE INCOME ON LAST TAX RETURN: $______

OCCUPATION AT MARRIAGE: ______

B. INFORMATION ABOUT YOUR SPOUSE

SPOUSE’S FULL NAME:______

SPOUSE’S PRESENT ADDRESS:______

______

SPOUSE’S HOME PHONE: ______WORK PHONE: ______FAX: ______

SPOUSE’S DATE OF BIRTH: ______PRESENT AGE: ______

PLACE OF BIRTH: ______

MAIDEN NAME: ______

SURNAME BEFORE THIS MARRIAGE: ______

MARITAL STATUS AT TIME OF MARRIAGE:

Single: _____Widowed: _____Divorced: _____

OCCUPATION: ______

EMPLOYER’S NAME AND ADDRESS:

______
______

HOW LONG AT THAT EMPLOYER? ______

GROSS ANNUAL INCOME: $______

FREQUENCY OF PAYMENT: Bi-weekly: _____ Bi-monthly: _____ Monthly: _____

TOTAL INCOME ON LAST TAX RETURN: $______

NET TAXABLE INCOME ON LAST TAX RETURN: $______

SPOUSE’S OCCUPATION AT MARRIAGE: ______

C. MARITAL HISTORY

DATE OF COHABITATION: ______

DATE OF MARRIAGE: ______

DO YOU HAVE A GOVERNMENT-ISSUED MARRIAGE CERTIFICATE? ______

PLACE OF MARRIAGE: (City, Province, Country) ______

SEPARATION DATE: ______

REASONS FOR SEPARATION: ______

______

HAVE YOU OR YOUR SPOUSE BEEN RESIDENT IN ALBERTA FOR AT LEAST ONE YEAR?

Yes: _____No: _____

GROUNDS FOR DIVORCE:_____One year separation (no fault)

_____Adultery (committed by your spouse)

_____Physical or mental cruelty

DO YOU WANT SUPPORT FOR YOURSELF?

Yes: _____No: _____

AMOUNT: $______

HAVE YOU COMMENCED DIVORCE PROCEEDINGS AGAINST YOUR SPOUSE IN THE PAST? Yes: _____ No: _____

IF YES, IN WHICH PROVINCE? ______

WHAT WAS DONE ABOUT THE ACTION? ______

______

DID EITHER SPOUSE TAKE TIME OFF WORK DURING THE MARRIAGE?
Yes: _____No: _____

IF YES, EXPLAIN: ______

______

DO YOU HAVE ANY DESIRE TO BECOME RECONCILED WITH YOUR SPOUSE?

Yes: _____No: _____

IF NOT, WHY? ______

______

HAVE ANY EFFORTS TO RECONCILE BEEN MADE SINCE SEPARATION?

Yes: _____No: _____

IF YES, EXPLAIN: ______

______

DO YOU KNOW THAT MARRIAGE COUNSELLING, GUIDANCE FACILITIES AND MEDIATION SERVICES ARE AVAILABLE TO YOU? Yes: _____ No: _____

D. CHILDREN’S ISSUES

FULL NAME:BIRTH DATE:PRESENT AGE:

______

DO ANY OF YOUR CHILDREN HAVE SPECIAL NEEDS: Yes: _____No: _____

IF YES, EXPLAIN: ______

______

PROPOSAL FOR CUSTODY OF CHILDREN (Joint, Sole, Shared Parenting, etc.):

______

PROPOSAL FOR ACCESS TO CHILDREN BY NON-CUSTODIAL PARENT:

______

PROPOSAL FOR CHILD SUPPORT:

______

TOPICS TO DISCUSS:

CHILD CARE EXPENSES: ______

MEDICAL/DENTAL INSURANCE PREMIUMS: ______

HEALTH RELATED EXPENSES THAT EXCEED INSURANCE: ______

EXTRAORDINARY EXPENSES FOR EDUCATION: ______

POST-SECONDARY EDUCATION: ______

EXTRAORDINARY EXPENSES FOR EXTRACURRICULAR ACTIVITIES: ______

REASONABLENESS OF THE EXPENSE: ______

ANY OTHER CONTRIBUTIONS AVAILABLE? ______

ANY CLAIMS FOR UNDUE HARDSHIP? ______

E. MATRIMONIAL PROPERTY

MATRIMONIAL HOME:

(1) MKT VALUE(2) 1st MORTGAGE(3) 2nd MORTGAGEEQUITY

(Balance) (Balance)(1-(2+3)

______

OTHER REAL ESTATE:

(1) MKT VALUE(2) 1st MORTGAGE(3) 2nd MORTGAGEEQUITY

(Balance) (Balance)(1-(2+3)

______

VEHICLES:

Year: ______Make/Model: ______Value: $______Debts: $______

Who drives it? ______

Year: ______Make/Model: ______Value: $______Debts: $______

Who drives it? ______

Year: ______Make/Model: ______Value: $______Debts: $______

Who drives it? ______

REGISTERED RETIREMENT SAVINGS PLANS:

Current Value: $______In who’s name? ______Where held? ______

OTHER INVESTMENTS/SAVINGS/TERM DEPOSITS/BANK ACCOUNTS:

In who’s name? ______Value: $______Where held? ______

YOUR EMPLOYMENT PENSIONS:

EMPLOYER: ______

YEARS OF CONTRIBUTION DURING MARRIAGE: ______

YOUR SPOUSE’S EMPLOYMENT PENSIONS:

EMPLOYER: ______

YEARS OF CONTRIBUTION DURING MARRIAGE: ______

BUSINESSES/CORPORATE INTERESTS:

NAME OF COMPANY OR BUSINESS: ______

NUMBER OF SHARES: ______

VALUE OF SHARES: $______

REGISTERED OFFICE: ______

WHO ARE THE OFFICERS AND DIRECTORS?

______

OTHER ASSETS:

DESCRIPTION: ______OWNED BY: ______VALUE: $______

DEBTS:

CREDITOR: ______BALANCE OWING: $______

SECURITY: ______MONTHLY PAYMENT: $______

CREDITOR: ______BALANCE OWING: $______

SECURITY: ______MONTHLY PAYMENT: $______

CREDITOR: ______BALANCE OWING: $______

SECURITY: ______MONTHLY PAYMENT: $______

CREDITOR: ______BALANCE OWING: $______

SECURITY: ______MONTHLY PAYMENT: $______

EXEMPTIONS: (ie: inheritances, value of assets owned at marriage, proceeds of insurance policies, etc.)

HUSBAND:TRACED TO:

______

WIFE:TRACED TO:

______

DO YOU HAVE ANY REASON TO CLAIM AN UNEQUAL DIVISION OF PROPERTY ACQUIRED DURING YOUR MARRIAGE?

______

HAS ANY PROPERTY BEEN SOLD OR TRANSFERRED TO ANYONE IN THE LAST YEAR?

______

1 / Macleod Place II, 5th Floor, 5940 Macleod Trail S.W., Calgary, Alberta T2H 2G4
ph. 403.238.0000 email